93 results on '"Cosmin Mihai Vesa"'
Search Results
2. Molecular Mechanisms of Metabolic Syndrome
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Cosmin Mihai Vesa, Dana Carmen Zaha, and Simona Gabriela Bungău
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n/a ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Metabolic syndrome represents a cluster of conditions, such as abdominal obesity, hypertension, dyslipidemia, and hyperglycemia, that are highly prevalent in developed countries because of unhealthy lifestyles [...]
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- 2024
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3. Oxidative stress and metabolic syndrome in acne vulgaris: Pathogenetic connections and potential role of dietary supplements and phytochemicals
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Alexa Florina Bungau, Andrei Flavius Radu, Simona Gabriela Bungau, Cosmin Mihai Vesa, Delia Mirela Tit, and Laura Maria Endres
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Oxidative stress ,Metabolic syndrome ,Acne vulgaris ,Supplements ,Phytochemicals ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Acne vulgaris is a highly prevalent skin condition caused by androgen-induced elevated sebum secretion, abnormal keratinization, bacterial colonization, and inflammation. Current research indicates a link between acne vulgaris and the metabolic syndrome, a group of disorders that includes obesity, insulin resistance, hypertension, and dyslipidemia. This link is thought to be modulated by excessive concentrations of oxidative stress markers and chronic inflammation, which are included in the pathophysiological mechanisms shared by both conditions. Excessive generation of reactive oxygen species damages cellular components and initiates an inflammatory response, hence promoting the development of both disorders. The current narrative review focuses on the molecular implications of inflammatory, hormonal, and environmental factors in the acne-metabolic syndrome correlation. Furthermore, it outlines the current state of knowledge related to the phyto-therapeutic approach to these conditions as an adjuvant strategy to allopathic treatment, but future multicenter and larger-scale research studies are needed establish new algorithms to be included in the future management of patients with these conditions.
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- 2023
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4. Exploring the Metabolic and Endocrine Preconditioning Associated with Thyroid Disorders: Risk Assessment and Association with Acne Severity
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Alexa Florina Bungau, Delia Mirela Tit, Simona Gabriela Bungau, Cosmin Mihai Vesa, Andrei-Flavius Radu, Ruxandra Cristina Marin, Laura Maria Endres, and Lavinia-Cristina Moleriu
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acne ,metabolic preconditioning ,endocrine preconditioning ,hormonal imbalance ,metabolic syndrome ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Metabolic preconditioning, characterized by conditions like obesity and insulin resistance syndrome, disrupts hormonal balance. Elevated androgen levels stimulate excessive sebum production and follicular cell proliferation, leading to acne lesions. Similarly, thyroid hormone imbalances affect sebaceous gland activity, epidermal lipid composition, and skin cell turnover, impacting acne occurrence and severity. This study aimed to assess the potential contribution of metabolic and endocrine preconditions to acne development. A total of 389 patients diagnosed with acne were included and divided into three groups: the metabolic precondition group (MPG, N = 163, 41.9%), the endocrine precondition group (EPG, N = 162, 41.65%), and the control group (CG, N = 89, 22.88%). Data related to the degree of acne severity and comorbidities of interest were collected from the patients’ medical records. In the groups with concomitant diseases, moderate and severe acne were significantly more prevalent (56.44% and 41.10% in MPG, and 35.80% and 61.11% in EPG) compared to the control group (5.61% and 4.89%). The most prevalent preconditions observed were insulin resistance syndrome in MPG (63.8%) and autoimmune thyroiditis in EPG (95.06%). Significant age-related differences in acne severity were found across all study groups (p < 0.05). In MPG, the age variable was significantly higher in the presence of mild acne, while in EPG, the age variable was significantly lower for the mild acne group. A positive association was observed between the severity of acne and insulin resistance syndrome, obesity, autoimmune thyroiditis, and hypothyroidism (p < 0.05). Risk analysis indicated a significantly higher risk (RR > 1, 95% CI RR > 1, p < 0.001) of developing moderate and severe acne in the presence of these preconditions. The presence of both metabolic and endocrine preconditions significantly increased the likelihood of developing severe acne, leading to the hypothesis that both conditions may be contributing factors to the development of acne.
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- 2024
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5. Clinical Implications of Dietary Probiotic Supplement (Associated with L-Glutamine and Biotin) in Ulcerative Colitis Patients’ Body Composition and Quality of Life
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Flavia Maria Pavel, Simona Gabriela Bungau, Delia Mirela Tit, Timea Claudia Ghitea, Ruxandra Cristina Marin, Andrei-Flavius Radu, Radu Dumitru Moleriu, Tiberia Ilias, Cristian Bustea, and Cosmin Mihai Vesa
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inflammatory bowel diseases ,ulcerative colitis ,dysbiosis ,body composition ,quality of life ,probiotic ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Patients with ulcerative colitis (UC) are reported to have changes in body structure, with negative impact on the course of disease. This study explored the effects of a standardized nutritional supplement containing five bacterial strains of at least five billion bacteria (Bifidobacterium infantis, Bifidobacterium animalis, Lactobacillus bulgaricus, Lactobacillus helveticus, and Enterococcus faecium), L-glutamine, and biotin on the body composition and quality of life of patients with UC. Ninety-three patients over 18 years of age with a confirmed diagnosis of UC, for whom body composition could be accurately determined, were included in this observational follow-up randomized study. These patients were split into two groups: UC-P (44 patients with dietary counselling and supplement with probiotics) and UC-NP (49 patients with dietary counselling, without supplement). Body composition was assessed using the multifrequency bioelectrical impedance device, and the quality of life related to UC was evaluated by applying the short inflammatory bowel disease questionnaire (SIBDQ). The results showed that the average value of muscular mass (MM) and sarcopenic index (SMI) significantly increased (p = 0.043, respectively, p = 0.001) and a large fraction (p = 0.001) of patients had their SMI levels normalized in the UC-P group compared with UC-NP group. The extracellular water to total body water ratio (ECW/TBW) also had significantly different mean values (p = 0.022), favoring the UC-P group. By testing the differences between the average values of body composition parameters before and after treatment, we obtained significant results in body mass index (BMI) (p = 0.046), fat free mass (FFM) (p < 0.001), and ECW/TBW ratio (p = 0.048). The SIBDQ total score increased significantly (p < 0.001) in the UC-P group and was more strongly associated with changes in body parameters. Supplementation with probiotics associated with L-glutamine and biotin can improve body composition parameters, which in turn implies an increase in the overall quality of life of patients with UC.
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- 2023
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6. Antioxidant and Hypoglycemic Potential of Essential Oils in Diabetes Mellitus and Its Complications
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Simona Gabriela Bungau, Cosmin Mihai Vesa, Cristian Bustea, Anamaria Lavinia Purza, Delia Mirela Tit, Mihaela Cristina Brisc, and Andrei-Flavius Radu
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antioxidants ,essential oil ,diabetes mellitus ,phytochemistry ,bibliometric analysis ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Since the earliest times, essential oils (EOs) have been utilized for medicinal and traditional purposes. However, in recent decades, an increasing interest has developed due to the need to rediscover herbal remedies and adjuvant therapies for the management of various diseases, particularly chronic ones. The present narrative review examines the potential for EOs to exert hypoglycemic and antioxidant effects in diabetes mellitus, analyzing the main publications having evaluated plant species with potentially beneficial effects through their phytocompounds in diabetes mellitus and its complications. Numerous species have shown promising characteristics that can be used in diabetes management. The hypoglycemic effects of these EOs are attributed to their capacity to stimulate glucose uptake, suppress glucose production, and increase insulin sensitivity. Moreover, EOs can alleviate the oxidative stress by manifesting their antioxidant effects via a variety of mechanisms, including the scavenging of free radicals, the regulation of antioxidant enzymes, and the decreasing of lipid peroxidation, due to their diverse chemical composition. These findings demonstrate the possible benefits of EOs as adjuvant therapeutic agents in the management of diabetes and its complications. The use of EOs in the treatment of diabetes shows good potential for the development of natural and effective strategies to enhance the health outcomes of people with this chronic condition, but additional experimental endorsements are required.
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- 2023
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7. Plants-based medicine implication in the evolution of chronic liver diseases
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Monica Foghis, Simona Gabriela Bungau, Alexa Florina Bungau, Cosmin Mihai Vesa, Anamaria Lavinia Purza, Alexandra Georgiana Tarce, Delia Mirela Tit, Annamaria Pallag, Tapan Behl, Syed Shams ul Hassan, and Andrei-Flavius Radu
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Herbal medicine ,Plants-based active compounds ,Dietary supplements ,Non-alcoholic fatty liver disease ,Chronic liver diseases ,Hepatitis ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Hepatic disorders are considered major health problems, due to their high incidence, increased risk of chronicling or death and the costs involved in therapies. A large number of patients with chronic liver diseases use herbal medicines and dietary supplements in parallel with allopathic treatment. The current review provides a thorough analysis of the studies conducted on the most important species of medicinal plants used in this disease, bioactive compounds and on the activity of herbal medicines in the evolution of chronic liver diseases. However, a negative aspect is that there is frequently a lack of comprehensive data on the progression of the illness and the living standards of patients who are affected when evaluating the effects of these phytocomponents on the evolution of chronic liver disease, the patients' health, and their quality of life. It is essential to take this impairment into account when evaluating the long-term effects of herbal treatments on the health of individuals who suffer from liver illness. Bioactive phytocomponents may be a suitable source for the development of novel medications due to the correlation between traditional uses and medical advances. Additional high-quality preclinical examinations utilizing cutting-edge approaches are needed to assess safety and effectiveness and to detect, categorize, and standardize the active substances and their formulations for the most suitable therapeutic management of liver illnesses.
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- 2023
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8. The Treatment with Interleukin 17 Inhibitors and Immune-Mediated Inflammatory Diseases
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Laura Țiburcă, Marius Bembea, Dana Carmen Zaha, Alexandru Daniel Jurca, Cosmin Mihai Vesa, Ioana Adela Rațiu, and Claudia Maria Jurca
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IL-17 inhibitor ,inflammatory intestinal disease ,Crohn’s disease ,ulcerative colitis ,Biology (General) ,QH301-705.5 - Abstract
IL-17 inhibitors (IL-17i) are medicines used to treat dermatological and rheumatic diseases They belong to a class of medicines called biological disease-modifying anti-rheumatic drugs (bDMARDs). This class of drugs has had a major impact on the therapy of autoimmune diseases, being much safer and more effective than treatment with small molecules. At the same time, they have highly beneficial effects on skin and joint changes, and their efficacy has been extensively monitored and demonstrated in numerous clinical trials. More and more such drugs are still being discovered today to ensure the best possible treatment of these patients, but more frequently and relatively constantly three agents are used. Two of them (Secukinumab and Ixekizumab) inhibit IL-17A directly, and the third, Brodamulab, inhibits the IL-17A receptor. Although they are extremely effective in the treatment of these diseases, sometimes their administration has been associated with paradoxical effects, i.e., there is an exacerbation of the inflammatory process. Tough, clinical trials of IL-17i have described cases of exacerbation or even onset of inflammatory bowel disease (IBD), such as Crohn’s disease and ulcerative colitis, after administration of these drugs in patients previously diagnosed with psoriasis (PS), psoriatic arthritis (PsA), or ankylosing spondylitis (AS). The pathophysiological mechanism of action is not well understood at present. One explanation would be that this hyperreactive inflammatory process would be triggered by Interferon 1 derived from dendritic plasma cells. Even though there are many reports in the recent literature about the role of IL17i in the onset of IBD, conclusions of studies do not converge. Some of them show an increased incidence of IBD in patients treated with IL17i, while some others affirm their safety of them. In the near future we will surely have more data emerging from ongoing meta-analyses regarding safety of use IL17i in patients who are at risk of developing IBD. Clinical and paraclinical evaluation (inflammatory intestinal markers) are carefully advised before recommending treatment with IL-17i and after initiation of treatment, and prospective surveillance by clinical and biomarkers of patients treated with IL-17i is absolutely essential to capture the onset of IBD.
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- 2022
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9. Cardiometabolic Risk: Characteristics of the Intestinal Microbiome and the Role of Polyphenols
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Ioana Mariana Haș, Delia Mirela Tit, Simona Gabriela Bungau, Flavia Maria Pavel, Bernadette-Emoke Teleky, Dan Cristian Vodnar, and Cosmin Mihai Vesa
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cardiometabolic risk ,gut microbiota ,microbiome ,polyphenols ,dysbiosis ,prebiotics ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Cardiometabolic diseases like hypertension, type 2 diabetes mellitus, atherosclerosis, and obesity have been associated with changes in the gut microbiota structure, or dysbiosis. The beneficial effect of polyphenols on reducing the incidence of this chronic disease has been confirmed by numerous studies. Polyphenols are primarily known for their anti-inflammatory and antioxidant properties, but they can also modify the gut microbiota. According to recent research, polyphenols positively influence the gut microbiota, which regulates metabolic responses and reduces systemic inflammation. This review emphasizes the prebiotic role of polyphenols and their impact on specific gut microbiota components in patients at cardiometabolic risk. It also analyzes the most recent research on the positive effects of polyphenols on cardiometabolic health. While numerous in vitro and in vivo studies have shown the interaction involving polyphenols and gut microbiota, additional clinical investigations are required to assess this effect in people.
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- 2023
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10. Emerging Insights into the Applicability of Essential Oils in the Management of Acne Vulgaris
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Alexa Florina Bungau, Andrei-Flavius Radu, Simona Gabriela Bungau, Cosmin Mihai Vesa, Delia Mirela Tit, Anamaria Lavinia Purza, and Laura Maria Endres
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acne vulgaris ,antioxidants ,essential oils ,phytochemistry ,Organic chemistry ,QD241-441 - Abstract
The occurrence of pustules, comedones, nodules, and cysts defines acne vulgaris, a prevalent chronic inflammatory dermatological condition. In the past few decades, essential oils extracted from varied natural sources have acquired recognition due to their potential medicinal applications in acne therapy. However, there is not yet sufficient medical data to fully characterize this interaction. Multiple factors contribute to the development of acne vulgaris, including excessive sebaceous production, inflammatory processes, hyperkeratinization, and infection with Cutibacterium acnes. Essential oils, including oregano, lavender, lemon grass, myrtle, lemon, thyme, eucalyptus, rosemary, and tea tree, have been found to possess anti-inflammatory, antioxidant, and antimicrobial properties, which may target the multifactorial causes of acne. Analytical methods for determining antioxidant potential (i.e., total phenolic content, diphenyl-1-picrylhydrazyl free radical scavenging assay, reducing power assay, ferrous ion chelating activity, thiobarbituric acid reactive species assay, β-carotene bleaching assay, etc.) are essential for the evaluation of these essential oils, and their method optimization is crucial. Further studies could include the development of novel acne treatments incorporating essential oils and an assessment of their efficacy in large clinical trials. In addition, further research is necessary to ascertain the mechanisms of action of essential oils and their optimal doses and safety profiles for optimal implementation in the management of acne vulgaris.
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- 2023
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11. The Crucial Role of Diet Therapy and Selenium on the Evolution of Clinical and Paraclinical Parameters in Patients with Metabolic Syndrome
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Adrian Marius Danciu, Timea Claudia Ghitea, Alexa Florina Bungau, and Cosmin Mihai Vesa
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Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Oxidative stress (OS) is associated with metabolic syndrome (MS) and represents a complex disease association that has become a major challenge in the field of public health. The aim of this study was to investigate the effectiveness of introducing selenium in the management of OS, while considering a balanced diet based on a healthy lifestyle and dietary therapy. A total of 206 individuals participated voluntarily in the study, divided into three groups: the control group with 35 individuals (17.0%) designated as control lot (LC), the group undergoing diet therapy with 119 individuals (57.8%) designated as diet therapy lot (LD), and the group undergoing diet therapy supplemented with selenium consisting of 52 individuals (25.2%) designated as diet therapy with selenium lot (LD + Se). The study assessed various clinical parameters (such as body mass index (BMI), body weight status, fat mass, visceral fat, and sarcopenic index), paraclinical parameters (including HOMA index, cholesterol, triglycerides, C-reactive protein, and glycosylated haemoglobin (HGS)), as well as OS parameters (measured using the FORD test, FORT test, and MIXED test). The LD + Se group demonstrated the most favourable results in terms of BMI reduction, decreased fat and visceral mass, reduced levels of C-reactive protein, and improved glycosylated haemoglobin levels. By implementing a balanced diet therapy and supplementing the diet with selenium, it was possible to achieve a reduction in adipose tissue and glycosylated haemoglobin levels, ultimately contributing to the reduction of OS in the body.
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- 2023
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12. Oxidative stress – Complex pathological issues concerning the hallmark of cardiovascular and metabolic disorders
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Dragos Rotariu, Emilia Elena Babes, Delia Mirela Tit, Madalina Moisi, Cristiana Bustea, Manuela Stoicescu, Andrei-Flavius Radu, Cosmin Mihai Vesa, Tapan Behl, Alexa Florina Bungau, and Simona Gabriela Bungau
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Oxidative stress ,Reactive oxygen species ,Cardiovascular risk factors ,Homeostasis ,Coronary artery disease ,Hypertension ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Oxidative stress is a complex biological process characterized by the excessive production of reactive oxygen species (ROS) that act as destroyers of the REDOX balance in the body and, implicitly, inducing oxidative damage. All the metabolisms are impaired in oxidative stress and even nucleic acid balance is influenced. ROS will promote structural changes of the tissues and organs due to interaction with proteins and phospholipids. The constellation of the cardiovascular risk factors (CVRFs) will usually develop in subjects with predisposition to cardiac disorders. Oxidative stress is usually related with hypertension (HTN), diabetes mellitus (DM), obesity and cardiovascular diseases (CVDs) like coronary artery disease (CAD), cardiomyopathy or heart failure (HF), that can develop in subjects with the above-mentioned diseases. Elements describing the complex relationship between CVD and oxidative stress should be properly explored and described because prevention may be the optimal approach. Our paper aims to expose in detail the complex physiopathology of oxidative stress in CVD occurrence and novelties regarding the phenomenon. Biomarkers assessing oxidative stress or therapy targeting specific pathways represent a major progress that actually change the outcome of subjects with CVD. New antioxidants therapy specific for each CVD represents a captivating and interesting future perspective with tremendous benefits on subject’s outcome.
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- 2022
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13. Micropulse Laser Therapy as an Integral Part of Eye Disease Management
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Flaviu Bodea, Simona Gabriela Bungau, Mihaela Alexandra Bogdan, Cosmin Mihai Vesa, Ada Radu, Alexandra Georgiana Tarce, Anamaria Lavinia Purza, Delia Mirela Tit, Cristian Bustea, and Andrei-Flavius Radu
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micropulse laser therapy ,ocular diseases ,diabetic macular edema ,glaucoma ,laser treatment ,ophthalmology ,Medicine (General) ,R5-920 - Abstract
Ocular diseases can significantly impact vision and quality of life through pathophysiological alterations to the structure of the eye. The management of these conditions often involves a combination of pharmaceutical interventions, surgical procedures, and laser therapy. Laser technology has revolutionized many medical fields, including ophthalmology, offering precise and targeted treatment options that solve some of the unmet needs of other therapeutic strategies. Conventional laser techniques, while effective, can generate excessive thermal energy, leading to collateral tissue damage and potential side effects. Compared to conventional laser techniques, micropulse laser therapy delivers laser energy in a pulsed manner, minimizing collateral damage while effectively treating target tissues. The present paper highlights the advantages of micropulse laser therapy over conventional laser treatments, presents the implications of applying these strategies to some of the most prevalent ocular diseases, and highlights several types and mechanisms of micropulse lasers. Although micropulse laser therapy shows great potential in the management of ocular diseases, further research is needed to optimize treatment protocols, evaluate long-term efficacy, and explore its role in combination therapies.
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- 2023
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14. Use of anticoagulant drugs in patients with atrial fibrillation. Does adherence to therapy have a prognostic impact?
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Mirela Marioara Toma, Simona Gabriela Bungau, Delia Mirela Tit, Madalina Ioana Moisi, Cristiana Bustea, Cosmin Mihai Vesa, Tapan Behl, Manuela Stoicescu, Cristina Mihaela Brisc, Lavinia Anamaria Purza, Daniela Gitea, and Camelia Cristina Diaconu
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Atrial fibrillations ,Oral anticoagulant drugs ,Adherence ,Compliance ,Prognostic impact ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Anticoagulant therapy represents a pivotal element that strongly influences the thromboembolic risk of non-valvular atrial fibrillation (NVAF) subjects. The main purpose of this review was to identify issues and suggest strategies to improve the oral anticoagulants (OACs) treatment adherence, which is the most important predictor of NVAF outcome. Advantages, efficacy, and impact of these drugs on patients’ prognosis were revealed in important clinical trials on large cohorts of patients and are often prescribed nowadays. A real-life data registry, the Global Anticoagulant Registry in the Field-Atrial Fibrillation (GARFIELD-AF) analyzed the profile and outcome of patients diagnosed with NVAF receiving oral antithrombotic treatment. The observations gathered in the registry were crucial for identifying relevant elements that clinicians must improve, such as adherence strategies and predisposing factors that correlated with stroke. Adherence to OACs in AF patients is essential from the viewpoint of clinical efficacy and safety. Major adverse events and negative outcome are correlated with a weak anticoagulation control caused by an ineffective treatment adherence strategy. Solving the issue of oral anticoagulation adherence is possible using new technologies, but future directions should be explored. Mobile phone applications centered on patients’ needs, telemedicine programs that evaluate patients’ evolution and detect adverse reactions or events, encouraging an adequate management of the event without interruption of OACs, represent perspectives with a major impact on treatment adherence.
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- 2022
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15. Novel Molecules in Diabetes Mellitus, Dyslipidemia and Cardiovascular Disease
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Cosmin Mihai Vesa and Simona Gabriela Bungau
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n/a ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
The purpose of this Special Issue is to present the impact in clinical practice as well as in medical research of novel molecules that have been introduced in the treatment of diabetes mellitus, dyslipidaemia, and cardiovascular disease [...]
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- 2023
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16. Therapeutic dilemmas in addressing SARS-CoV-2 infection: Favipiravir versus Remdesivir
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Paul Andrei Negru, Andrei-Flavius Radu, Cosmin Mihai Vesa, Tapan Behl, Mohamed M. Abdel-Daim, Aurelia Cristina Nechifor, Laura Endres, Manuela Stoicescu, Bianca Pasca, Delia Mirela Tit, and Simona Gabriela Bungau
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Favipiravir ,Remdesivir ,SARS-CoV-2 ,COVID-19 ,Antiviral molecules ,Antiviral resistance ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Coronavirus disease 2019 (COVID-19) represents an unmet clinical need, due to a high mortality rate, rapid mutation rate in the virus, increased chances of reinfection, lack of effectiveness of repurposed drugs and economic damage. COVID-19 pandemic has created an urgent need for effective molecules. Clinically proven efficacy and safety profiles have made favipiravir (FVP) and remdesivir (RDV) promising therapeutic options for use against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Even though both are prodrug molecules with an antiviral role based on a similar mechanism of action, differences in pharmacological, pharmacokinetic and pharmacotoxicological mechanisms have been identified. The present study aims to provide a comprehensive comparative assessment of FVP and RDV against SARS-CoV-2 infections, by centralizing medical data provided by significant literature and authorized clinical trials, focusing on the importance of a better understanding of the interactions between drug molecules and infectious agents in order to improve the global management of COVID-19 patients and to reduce the risk of antiviral resistance.
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- 2022
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17. Comorbidities, Associated Diseases, and Risk Assessment in COVID-19—A Systematic Review
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Andreea Fitero, Simona Gabriela Bungau, Delia Mirela Tit, Laura Endres, Shamim Ahmad Khan, Alexa Florina Bungau, Ioana Romanul, Cosmin Mihai Vesa, Andrei-Flavius Radu, Alexandra Georgiana Tarce, Mihaela Alexandra Bogdan, Aurelia Cristina Nechifor, and Nicoleta Negrut
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Medicine - Abstract
It is considered that COVID-19’s pandemic expansion is responsible for the particular increase in deaths, especially among the population with comorbidities. The health system is often overwhelmed by the large number of cases of patients addressing it, by the regional limitation of funds, and by the gravity of cases at subjects suffering from this pathology. Several associated conditions including diabetes, cardiovascular illnesses, obesity, persistent lung condition, neurodegenerative diseases, etc., increase the mortality risk and hospitalization of subjects suffering from COVID-19. The rapid identification of patients with increased risk of death from the SARS-CoV-2 virus, the stratification in accordance with the risk and the allocation of human, financial, and logistical resources in proportion must be a priority for health systems worldwide.
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- 2022
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18. Reviewing the Modern Therapeutical Options and the Outcomes of Sacubitril/Valsartan in Heart Failure
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Diana-Carina Iovanovici, Simona Gabriela Bungau, Cosmin Mihai Vesa, Madalina Moisi, Elena Emilia Babes, Delia Mirela Tit, Tunde Horvath, Tapan Behl, and Marius Rus
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sacubitril/valsartan ,mortality ,morbidity ,heart failure ,ejection fraction ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Sacubitril/valsartan (S/V) is a pharmaceutical strategy that increases natriuretic peptide levels by inhibiting neprilysin and regulating the renin-angiotensin-aldosterone pathway, blocking AT1 receptors. The data for this innovative medication are mainly based on the PARADIGM-HF study, which included heart failure with reduced ejection fraction (HFrEF)-diagnosed patients and indicated a major improvement in morbidity and mortality when S/V is administrated compared to enalapril. A large part of the observed favorable results is related to significant reverse cardiac remodeling confirmed in two prospective trials, PROVE-HF and EVALUATE-HF. Furthermore, according to a subgroup analysis from the PARAGON-HF research, S/V shows benefits in HFrEF and in many subjects having preserved ejection fraction (HFpEF), which indicated a decrease in HF hospitalizations among those with a left ventricular ejection fraction (LVEF) < 57%. This review examines the proven benefits of S/V and highlights continuing research in treating individuals with varied HF characteristics. The article analyses published data regarding both the safeness and efficacy of S/V in patients with HF, including decreases in mortality and hospitalization, increased quality of life, and reversible heart remodeling. These benefits led to the HF guidelines recommendations updating and inclusion of S/V combinations a key component of HFrEF treatment.
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- 2022
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19. Morbidity and Mortality in Patients with Acute Coronary Syn-drome with and Without Chronic Kidney Disease and Physicans Atitude Regarding Theraphy in the Two Groups
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Mădălina Ioana Moisi, Cosmin Mihai Vesa, Larisa Roșan, Otilia Țica, Carmen Dana Zaha, Adriana Ardelean, Babeș Katalin, and Mircea Ioachim Popescu
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Public aspects of medicine ,RA1-1270 - Abstract
No Abstract
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- 2021
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20. Reviewing the Traditional/Modern Uses, Phytochemistry, Essential Oils/Extracts and Pharmacology of Embelia ribes Burm.
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Vineet Sharma, Dev Nath Singh Gautam, Andrei-Flavius Radu, Tapan Behl, Simona Gabriela Bungau, and Cosmin Mihai Vesa
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Embelia ribes Burm. ,Vidanga ,antioxidants ,essential oils/extracts ,embelin ,vilangin ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Objectives: Embelia ribes Burm. (E. ribes, Myrsinaceae), also known as Vidanga in Ayurveda, has been shown to have significant therapeutic benefits on several disorders, and its main chemical bioactive constituent, embelin, has the therapeutic potential to be converted into innovative drugs, which is why it has recently received considerable interest. In the present work, we provide a higher level of comprehension, awareness, and extensive knowledge of the traditional uses, phytochemistry, and pharmacological characteristics of E. ribes throughout the last several decades (February 1965 to June 2021), emphasizing the importance of the study of essential oils extracted from E. ribes, which show a major potential for exerting antioxidant and anti-inflammatory activity. Materials and Methods: Google Scholar, MEDLINE, EMBASE, Scifinder, Scopus, and ScienceDirect were used to conduct a thorough literature search. Results: E. ribes is high in essential oils, alkaloids, flavonoids, steroids, and phenolics, all of which have medicinal benefits. The essential oils/extracts and isolated chemical constituents exhibited antioxidant activity, wound healing, antidiabetic, central nervous system (CNS)-related disease, antiviral, antiobesity, cardioprotective, antifungal, antibacterial, and antifertility activity, among other promising pharmacological effects. Conclusion: The translation between traditional applications and modern medicine may make E. ribes a promising target for the implementation of innovative medication. To investigate the efficacy and safety profile of E. ribes, further high-quality preclinical studies using advanced methodologies are required.
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- 2022
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21. A Narrative Review of the Classical and Modern Diagnostic Methods of the No-Reflow Phenomenon
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Larisa Renata Pantea-Roșan, Simona Gabriela Bungau, Andrei-Flavius Radu, Vlad Alin Pantea, Mădălina Ioana Moisi, Cosmin Mihai Vesa, Tapan Behl, Aurelia Cristina Nechifor, Elena Emilia Babes, Manuela Stoicescu, Daniela Gitea, Diana Carina Iovanovici, and Cristiana Bustea
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diagnostic methods ,no-reflow phenomenon ,electrocardiogram ,echocardiogram ,thrombolysis ,acute myocardial infarction ,Medicine (General) ,R5-920 - Abstract
The incidence of the no-reflow (NR) phenomenon varies depending on the diagnostic criteria used. If just the angiographic criteria are considered (i.e., a degree of thrombolysis in myocardial infarction ≤2), it will be found that the incidence of NR is quite low; on the other hand, when the myocardial NR is taken into account (i.e., a decrease in the quality of myocardial reperfusion expressed by the degree of myocardial blush), the real incidence is higher. Thus, the early establishment of a diagnosis of NR and the administration of specific treatment can lead to its reversibility. Otherwise, regardless of the follow-up period, patients with NR have a poor prognosis. In the present work, we offer a comprehensive perspective on diagnostic tools for NR detection, for improving the global management of patients with arterial microvasculature damage, which is a topic of major interest in the cardiology field, due to its complexity and its link with severe clinical outcomes.
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- 2022
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22. Pleotropic Effects of Polyphenols in Cardiovascular System
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Tapan Behl, Simona Bungau, Keshav Kumar, Gokhan Zengin, Fazlullah Khan, Arun Kumar, Rajwinder Kaur, Thangaval Venkatachalam, Delia Mirela Tit, Cosmin Mihai Vesa, Ghita Barsan, and Danut-Eugeniu Mosteanu
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Polyphenol ,Cardiovascular disease ,Platelet aggregation ,Antioxidant defenses ,Hyperlipidemia ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Numerous epidemiological and clinical studies demonstrate the beneficial effects of naturally occurring, polyphenol supplementations, on cardiovascular system. The present review emphasizes on the risk factors associated with cardiovascular disorders (involving heart and blood vessels), and overview of preclinical and clinical trials on polyphenols for the treatment of cardiovascular diseases. The review collaborates PUBMED, Google Scholar and Research gate databases, which were explored using keywords and their combinations such as polyphenols, cardiovascular disease, flavonoids, atherosclerosis, cardiovascular risk factors and several others, to create an eclectic manuscript. The potency and efficacy of these polyphenols are mainly depending upon the amount of consumption and bioavailability. Recent data showed that polyphenols also exert beneficial actions on vascular system by blocking platelet aggregation and oxidation of low-density lipoprotein (LDL), ameliorating endothelial dysfunction, reducing blood pressure, improving antioxidant defenses and alleviating inflammatory responses. Several studies evidently support the cardioprotective actions mediated by polyphenols, however, some studies or long-term follow-up of human studies, did not demonstrate decisive outcomes because of variations in dose regimen and lack of appropriate controls. Therefore, more data is required to explore the therapeutic benefits of bioactive compounds as a preventive therapy for CVDs.
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- 2020
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23. Proposal of a Novel Risk Score for Determination of Coronary Artery Disease Risk in Newly Diagnosed Diabetes Patients
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Cosmin Mihai VESA, Carmen RADU, Loredana POPA, Claudia JURCA, Lucia DAINA, Cornelia BALA, Gabriela ROMAN, Mădălina MOISI, Amorin POPA, Mihaela POPOVICIU, Anca FERICIAN, and Dana ZAHA
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Public aspects of medicine ,RA1-1270 - Abstract
No Abstract
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- 2020
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24. Correlations between Diabetes Mellitus Self-Care Activities and Glycaemic Control in the Adult Population: A Cross-Sectional Study
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Mihaela Simona Popoviciu, Violeta Nicoleta Marin, Cosmin Mihai Vesa, Simona Diana Stefan, Roxana Adriana Stoica, Cristian Serafinceanu, Emanuele Maria Merlo, Ali A Rizvi, Manfredi Rizzo, Stefan Busnatu, and Anca Pantea Stoian
- Subjects
diabetes mellitus ,diabetes self-management questionnaire ,physical activity ,self-care activities ,glycaemic control ,prevention ,Medicine - Abstract
Although it is well known that lifestyle changes can affect plasma glucose levels, there is little formal evidence for the sustained effectiveness of exercise and diet in diabetes mellitus (DM) management. Self-care in DM refers to the real-life application of the knowledge that the patient gained during the education programmes. The goals are to bring about changes in the patient’s behaviour, thus improving glycaemic control. We evaluated the influence of DM self-care activities (SCA) on glycaemic control in a total of 159 patients with DM. Plasma glycated haemoglobin (HbA1c) levels were used to monitor glycaemic control, while SCA were assessed using the standardised Diabetes Self-Management Questionnaire (DSMQ). In our study, 53% of the patients had a HbA1c ≥ 7%. In univariate linear regression models, a statistically significant inverse association was observed between the HbA1c (the dependent variable) and both the DSMQ Dietary Control Score (R2 = 0.037, p = 0.0145) and the DSMQ Sum Score (R2 = 0.06, p = 0.0014). The mean absolute change in the HbA1c% associated with one standard deviation (SD) change in the DSMQ Sum Score, independent of the other significant variables retained in the compacted multivariate regression model, was −0.419% (confidence interval: 95%: from −0.18 to −0.65). Although the impact of the DSMQ Score was modest when compared to the other independent variables in the multivariate model, the findings emphasise the importance of maintaining optimal lifestyle changes to avoid hyperglycaemia and its complications. In conclusion, enhanced self-management of DM is associated with improved glucose control. In patients with chronic diseases such as DM, the role of streamlining SCA encompassing physical activity and proper dietary choices is imperative because of a significantly reduced access to healthcare globally as a result of the COVID-19 pandemic.
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- 2022
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25. Framing Cause-Effect Relationship of Acute Coronary Syndrome in Patients with Chronic Kidney Disease
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Mădălina Ioana Moisi, Simona Gabriela Bungau, Cosmin Mihai Vesa, Camelia Cristina Diaconu, Tapan Behl, Manuela Stoicescu, Mirela Mărioara Toma, Cristiana Bustea, Cristian Sava, and Mircea Ioachim Popescu
- Subjects
chronic kidney disease ,non-traditional risk factors ,ischemic coronary artery disease ,accelerated atherosclerosis ,acute coronary syndromes ,Medicine (General) ,R5-920 - Abstract
The main causes of death in patients with chronic kidney disease (CKD) are of cardiovascular nature. The interaction between traditional cardiovascular risk factors (CVRF) and non-traditional risk factors (RF) triggers various complex pathophysiological mechanisms that will lead to accelerated atherosclerosis in the context of decreased renal function. In terms of mortality, CKD should be considered equivalent to ischemic coronary artery disease (CAD) and properly monitored. Vascular calcification, endothelial dysfunction, oxidative stress, anemia, and inflammatory syndrome represents the main uremic RF triggered by accumulation of the uremic toxins in CKD subjects. Proteinuria that appears due to kidney function decline may initiate an inflammatory status and alteration of the coagulation—fibrinolysis systems, favorizing acute coronary syndromes (ACS) occurrence. All these factors represent potential targets for future therapy that may improve CKD patient’s survival and prevention of CV events. Once installed, the CAD in CKD population is associated with negative outcome and increased mortality rate, that is the reason why discovering the complex pathophysiological connections between the two conditions and a proper control of the uremic RF are crucial and may represent the solutions for influencing the prognostic. Exclusion of CKD subjects from the important trials dealing with ACS and improper use of the therapeutical options because of the declined kidney functioned are issues that need to be surpassed. New ongoing trials with CKD subjects and platelets reactivity studies offers new perspectives for a better clinical approach and the expected results will clarify many aspects.
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- 2021
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26. Severe Cardiac and Metabolic Pathology Induced by Steroid Abuse in a Young Individual
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Adrian Tirla, Cosmin Mihai Vesa, and Simona Cavalu
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anabolic ,steroids ,testosterone ,infarction ,diabetes ,dyslipidemia ,Medicine (General) ,R5-920 - Abstract
Androgenic-Anabolic Steroids (AAS) abuse is known to play an important role in causing the systemic inflammatory response and multiple-organ dysfunction in healthy individuals. Although many of the undesirable effects of steroid abuse have been reported, at present, little is known about the effect of anabolic supplements and the correlation between cardiac and metabolic pathology. This paper presents a case of a 25 year old patient with a complex medical history after 6 months of steroid administration. Myocardial infraction, dyslipidemia, obesity, hyperuricemia, secondary diabetes, and chronic renal disease were identified after clinical and para-clinical examinations. The particularities of this case were interpreted in the context of a literature review, highlighting the effect of multi-organ damage as a result of the uncontrolled use of anabolic steroid supplements.
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- 2021
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27. Highlighting the Relevance of Gut Microbiota Manipulation in Inflammatory Bowel Disease
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Flavia Maria Pavel, Cosmin Mihai Vesa, Gina Gheorghe, Camelia C. Diaconu, Manuela Stoicescu, Mihai Alexandru Munteanu, Elena Emilia Babes, Delia Mirela Tit, Mirela Marioara Toma, and Simona Bungau
- Subjects
gut microbiota ,supplements ,inflammatory bowel disease ,Crohn’s disease ,ulcerative colitis ,probiotics ,Medicine (General) ,R5-920 - Abstract
Two different conditions are included in inflammatory bowel disease (IBD), Crohn’s disease (CD) and ulcerative colitis (UC), being distinguished by chronic recurrence of gut inflammation in persons that are genetically predisposed and subjected to environmental causative factors. The normal structure of the gut microbiome and its alterations in IBD were defined in several microbial studies. An important factor in the prolonged inflammatory process in IBD is the impaired microbiome or “dysbiosis”. Thus, gut microbiome management is likely to be an objective in IBD treatment. In this review, we analyzed the existing data regarding the pathophysiological/therapeutic implications of intestinal microflora in the development and evolution of IBD. Furthermore, the main effects generated by the administration of probiotics, prebiotics, fecal transplantation, and phytochemicals supplementation were analyzed regarding their potential roles in improving the clinical and biochemical status of patients suffering from Crohn’s disease (CD) and ulcerative colitis (UC), and are depicted in the sections/subsections of the present paper. Data from the literature give evidence in support of probiotic and prebiotic therapy, showing effects such as improving remission rate, improving macroscopic and microscopic aspects of IBD, reducing the pro-inflammatory cytokines and interleukins, and improving the disease activity index. Therefore, the additional benefits of these therapies should not be ignored as adjuvants to medical therapy.
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- 2021
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28. Withaferin A—A Promising Phytochemical Compound with Multiple Results in Dermatological Diseases
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Simona Bungau, Cosmin Mihai Vesa, Areha Abid, Tapan Behl, Delia Mirela Tit, Anamaria Lavinia Purza, Bianca Pasca, Laura Maghiar Todan, and Laura Endres
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Withania somnifera ,withaferin A ,dermatology ,dermatological disorders ,melanoma ,Ayurvedic medicine ,Organic chemistry ,QD241-441 - Abstract
Withaferin A (WFA) was identified as the most active phytocompound of the plant Withania somnifera (WS) and as having multiple therapeutic/ameliorating properties (anticancer, antiangiogenic, anti-invasive, anti-inflammatory, proapoptotic, etc.) in case of various diseases. In drug chemistry, WFA in silico approaches have identified favorite biological targets, stimulating and accelerating research to evaluate its pharmacological activity—numerous anticancer effects manifested in various organs (breast, pancreas, skin, colon, etc.), antivirals, anti-infective, etc., which are not yet sufficiently explored. This paper is a synthesis of the most relevant specialized papers in the field that are focused on the use of WFA in dermatological diseases, describing its mechanism of action while providing, at the same time, details about the results of its testing in in vitro/in vivo studies.
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- 2021
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29. Non-Alcoholic Fatty Liver Disease and Cardiovascular Comorbidities: Pathophysiological Links, Diagnosis, and Therapeutic Management
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Alexandra Jichitu, Simona Bungau, Ana Maria Alexandra Stanescu, Cosmin Mihai Vesa, Mirela Marioara Toma, Cristiana Bustea, Stela Iurciuc, Marius Rus, Nicolae Bacalbasa, and Camelia Cristina Diaconu
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non-alcoholic fatty liver disease ,cardiovascular comorbidities ,pathophysiology ,treatment ,Medicine (General) ,R5-920 - Abstract
Non-alcoholic fatty liver disease (NAFLD) has a growing prevalence in recent years. Its association with cardiovascular disease has been intensively studied, and certain correlations have been identified. The connection between these two entities has lately aroused interest regarding therapeutic management. In order to find the best therapeutic options, a detailed understanding of the pathophysiology that links (NAFLD) to cardiovascular comorbidities is needed. This review focuses on the pathogenic mechanisms that are behind these two diseases and on the therapeutic management available at this time.
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- 2021
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30. Recognizing the Benefits of Pre-/Probiotics in Metabolic Syndrome and Type 2 Diabetes Mellitus Considering the Influence of Akkermansia muciniphila as a Key Gut Bacterium
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Raluca Anca Corb Aron, Areha Abid, Cosmin Mihai Vesa, Aurelia Cristina Nechifor, Tapan Behl, Timea Claudia Ghitea, Mihai Alexandru Munteanu, Ovidiu Fratila, Felicia Liana Andronie-Cioara, Mirela Marioara Toma, and Simona Bungau
- Subjects
prebiotics ,probiotics ,metabolic syndrome ,type 2 diabetes mellitus ,Akkermansia muciniphila ,gut bacterium ,Biology (General) ,QH301-705.5 - Abstract
Metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) are diseases that can be influenced by the structure of gut microbiota, whose improvement is often neglected in metabolic pathology. This review highlights the following main aspects: the relationship between probiotics/gut microbes with the pathogenesis of MetS, the particular positive roles of Akkermansia muciniphila supplementation in the onset of MetS, and the interaction between dietary polyphenols (prebiotics) with gut microbiota. Therefore, an extensive and in-depth analysis of the often-neglected correlation between gut microbiota and chronic metabolic diseases was conducted, considering that this topic continues to fascinate and stimulate researchers through the discovery of novel strains and their beneficial properties.
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- 2021
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31. Clinical Features and Outcome of Infective Endocarditis in a University Hospital in Romania
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Emilia Elena Babeș, Diana Anca Lucuța, Codruța Diana Petcheși, Andreea Atena Zaha, Cristian Ilyes, Alexandru Daniel Jurca, Cosmin Mihai Vesa, Dana Carmen Zaha, and Vlad Victor Babeș
- Subjects
endocarditis ,etiology ,correlations ,complications ,mortality ,Medicine (General) ,R5-920 - Abstract
Background and Objectives: Characterization of patients with endocarditis regarding demographic, clinical, biological and imagistic data, blood culture results and possible correlation between different etiologic factors and host status characteristics. Material and methods: This is a retrospective observational descriptive study conducted on patients older than 18 years admitted in the past 10 years, in the Cardiology Clinic of the Clinical County Emergency Hospital Oradea Romania, with clinical suspicion of bacterial endocarditis. Demographic data, clinical, paraclinical investigations and outcome were registered and analyzed. Results: 92 patients with definite infective endocarditis (IE) according to modified Duke criteria were included. The mean age of patients was 63.80 ± 13.45 years. A percent of 32.6% had health care associated invasive procedure performed in the 6 months before diagnosis of endocarditis. Charlson’s comorbidity index number was 3.53 ± 2.029. Most common clinical symptoms and signs were: shortness of breath, cardiac murmur, fever. Sixty-six patients had native valve endocarditis, 26 patients had prosthetic valve endocarditis and one patient was with congenital heart disease. Blood cultures were positive in 61 patients. Among positive culture patient’s staphylococcus group was the most frequently involved: Staphylococcus aureus (19.6%) and coagulase negative Staphylococcus (18.5%). Most frequent complications were heart failure, acute renal failure and embolic events. Conclusions: Staphylococcus aureus IE was associated with the presence of large vegetations, prosthetic valve endocarditis and intracardiac abscess. Coagulase negative Staphylococcus (CoNS) infection was associated with prosthetic valve dysfunction. Streptococcus gallolyticus etiology correlated with ischemic embolic stroke and the presence of large vegetations. Cardiovascular surgery was recommended in 67.4% of patients but was performed only on half of them. In hospital death occurred in 33.7% of patients and independent predictors of mortality were congestive heart failure and septic shock.
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- 2021
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32. Early Diagnosis of Pancreatic Cancer: The Key for Survival
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Gina Gheorghe, Simona Bungau, Madalina Ilie, Tapan Behl, Cosmin Mihai Vesa, Ciprian Brisc, Nicolae Bacalbasa, Vladiana Turi, Raluca Simona Costache, and Camelia Cristina Diaconu
- Subjects
pancreatic cancer ,carbohydrate antigen 19-9 (CA19.9) ,risk factors ,early diagnosis ,biomarkers ,Medicine (General) ,R5-920 - Abstract
Pancreatic cancer (PC) is one of the most aggressive forms of cancer. Negative prognosis is mainly due to the late diagnosis in advanced stages, when the disease is already therapeutically overcome. Studies in recent years have focused on identifying biomarkers that could play a role in early diagnosis, leading to the improvement of morbidity and mortality. Currently, the only biomarker widely used in the diagnosis of PC is carbohydrate antigen 19-9 (CA19.9), which has, however, more of a prognostic role in the follow-up of postoperative recurrence than a diagnostic role. Other biomarkers, recently identified as the methylation status of ADAMTS1 (A disintegrin and metalloproteinase with thrombospondin motifs 1) and BNC1 (zinc finger protein basonuclin-1) in cell-free deoxyribonucleic acid (DNA), may play a role in the early detection of PC. This review focuses on the diagnosis of PC in its early stages.
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- 2020
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33. Risk Factors Associated with Recurrent Clostridioides difficile Infection
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Nicoleta Negrut, Simona Bungau, Tapan Behl, Shamim Ahmad Khan, Cosmin Mihai Vesa, Cristiana Bustea, Delia Carmen Nistor-Cseppento, Marius Rus, Flavia-Maria Pavel, and Delia Mirela Tit
- Subjects
Clostridioides difficile ,recurrent disease ,risk factors ,antibiotic-associated diarrhea ,ATLAS score ,Charlson Comorbidity Index ,Medicine - Abstract
Clostridioides difficile (CD) is responsible for nosocomial diarrhea syndrome with possible severe progression. Recurrence of the disease induces higher health system costs, as well as exposes patients to additional health risks. Patients with recurrence of this disease are difficult to identify, so the purpose of this study is to quantify various demographic, clinical, and treatment factors that could prevent further progression to recurrence of the disease. In the period 2018–2019, about 195 patients were diagnosed with more than one episode of CDI in the three months following the first episode. The recurrence rate for CDI was 53.84% (60.95% for one episode and 39.05% for multiple episodes). Most commonly afflicted were 60–69-year-old patients, or those with higher Charlson Comorbidity Index (CCI). Multiple analyses associated cardiovascular (odds ratios (OR) = 3.02, 95% confidence intervals (CI) = 1.23–7.39, p = 0.015), digestive (OR = 3.58, 95% CI = 1.01–12.63, p = 0.047), dementia (OR = 3.26, 95% CI = 1.26–8.41, p = 0.014), immunosuppressive (OR = 3.88, 95% CI = 1.34–11.21, p = 0.012) comorbidities with recurrences. Risk factor identification in the first episode of CDI could lead to the implementation of treatment strategies to improve the patients’ quality of life affected by this disease.
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- 2020
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34. Clinical, Pathological and Microbiological Evaluation of Diabetic Foot Syndrome
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Bogdan Uivaraseanu, Simona Bungau, Delia Mirela Tit, Ovidiu Fratila, Marius Rus, Teodor Andrei Maghiar, Octavian Maghiar, Carmen Pantis, Cosmin Mihai Vesa, and Dana Carmen Zaha
- Subjects
diabetic foot syndrome ,ulcers ,infections ,antibiotics ,diabetes ,Medicine (General) ,R5-920 - Abstract
Background and objectives: Diabetic foot ulcer (DFU) is one of the serious complications of diabetes, being related to frequent and long-term hospitalisation, reduced quality of life of the patient, amputations, a high rate of morbidity and mortality. The bacterial aetiology is complex, sometimes involving more than one pathogen, playing a major role in the infection prognosis and development of microbial resistance. This study evaluated the current state of the aetiology, clinical and pathological characteristics of DFU in a single diabetes centre in order to provide some specific measures to prevent it. Materials and Methods: This retrospective study was conducted on patients with diabetes mellitus (252 individuals diagnosed with DFU) between January 2018–December 2019. All participants were assessed based on their clinical characteristics, including complications of diabetes and pathological and microbiological evaluations. Results: The present research revealed that diabetic foot ulcer prevalence was higher in males than in females and higher in type 2 diabetic patients than in type 1 diabetic patients. The patients with diabetic foot ulcer were older, had a higher body mass index (BMI), longer diabetic duration and had more diabetic complications, such as retinopathy, diabetic polyneuropathy and diabetic kidney disease, than patients without diabetic foot ulceration. Conclusions: Taking into account all factors involved, including the aetiology and the antibiotic susceptibility pattern of these isolates, planning the suitable treatment options of patients is possible.
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- 2020
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35. Current Data Regarding the Relationship between Type 2 Diabetes Mellitus and Cardiovascular Risk Factors
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Cosmin Mihai Vesa, Loredana Popa, Amorin Remus Popa, Marius Rus, Andreea Atena Zaha, Simona Bungau, Delia Mirela Tit, Raluca Anca Corb Aron, and Dana Carmen Zaha
- Subjects
diabetes ,cardiovascular risk ,pathogenic mechanisms ,SGLT-2 inhibitors ,GLP-1 agonists ,Medicine (General) ,R5-920 - Abstract
Reducing cardiovascular risk (CVR) is the main focus of diabetes mellitus (DM) management nowadays. Complex pathogenic mechanisms that are the subject of this review lead to early and severe atherosclerosis in DM patients. Although it is not a cardiovascular disease equivalent at the moment of diagnosis, DM subjects are affected by numerous cardiovascular complications, such as acute coronary syndrome, stroke, or peripheral artery disease, as the disease duration increases. Therefore, early therapeutic intervention is mandatory and recent guidelines focus on intensive CVR factor management: hyperglycaemia, hypertension, and dyslipidaemia. Most important, the appearance of oral or injectable antidiabetic medication such as SGLT-2 inhibitors or GLP-1 agonists has proven that an antidiabetic drug not only reduces glycaemia, but also reduces CVR by complex mechanisms. A profound understanding of intimate mechanisms that generate atherosclerosis in DM and ways to inhibit or delay them are of the utmost importance in a society where cardiovascular morbidity and mortality are predominant.
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- 2020
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36. Antibiotic Consumption and Microbiological Epidemiology in Surgery Departments: Results from a Single Study Center
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Dana Carmen Zaha, Simona Bungau, Diana Uivarosan, Delia Mirela Tit, Teodor Andrei Maghiar, Octavian Maghiar, Carmen Pantis, Ovidiu Fratila, Marius Rus, and Cosmin Mihai Vesa
- Subjects
antibiotics ,pathogens ,surgery ,dose ,bacteria ,susceptibility ,Therapeutics. Pharmacology ,RM1-950 - Abstract
The spectrum and antibiotic sensitivity of isolated strains vary between departments, hospitals, countries; the discrepancies are related to the use and dosage of these antibiotics. The purpose of our research was to compare the type of pathogens and the susceptibility of the isolated strains, as well as the use of antibiotics in the surgical departments of the Emergency Clinical County Hospital, Oradea, Romania; for one year, all the patients admitted to the mentioned sections were monitored. Antibiotic sensitivity of isolated strains was expressed using cumulative antibiogram. The total consumption of antibiotics was 479.18 DDD/1000 patient-days in the surgical sections. The most commonly used drugs were cephalosporins third and first generation, and clindamycin. Infections of wounds, urinary tract and fluids were most commonly diagnosed, and the most isolated was Escherichia coli, followed by Staphylococcus aureus and Enterococcus faecalis. The most commonly prescribed antimicrobial was ceftriaxone, but its sensitivity was low. This study revealed that the intake of antimicrobials in the surgical sections is increased and the comparison of antimicrobial prescriptions, sensitivity rates, and the spectrum of isolated pathogens showed differences between antimicrobials.
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- 2020
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37. Effects of probiotic supplementation on metabolic syndrome components in type 2 diabetes mellitus patients – a case-control study
- Author
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Areha Abid, Delia Mirela Tit, Simona Bungau, Gabriela Anca Angelescu, Anamaria Lavinia Purza, Cosmin Mihai Vesa, and Raluca Anca Corb Aron
- Subjects
Medicine (General) ,medicine.medical_specialty ,business.industry ,glucidic profile ,Case-control study ,Type 2 Diabetes Mellitus ,General Medicine ,lipidic profile ,medicine.disease ,Gastroenterology ,metabolic syndrome ,law.invention ,weight status ,Probiotic ,R5-920 ,law ,Internal medicine ,medicine ,Medicine ,type 2 diabetes ,Metabolic syndrome ,business - Abstract
Introduction. Probiotics are well-known adjuvants, used as complementary therapeutic agents in health (e.g. metabolic or gastrointestinal) disorders, considering their beneficial role on gut microbiota, and their support in immunity. The objective of the study. This research followed the impact of probiotic supplementation on some clinical parameters related to metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM) (weight status, body mass index, carbohydrate/ lipid profiles). Materials and methods. The comparative monitoring of the parameters was conducted over a 3- month period, on 41 subjects diagnosed with both MS and T2DM, who were separated into two groups, as follows: the study group (probiotics associated with allopathic treatment) and the control group (without probiotics). Results. Administration of dietary probiotics had a major impact on body weight, weight loss being significantly enhanced in the probiotic group than in the diet-only group (p=0.01). The effect of dietary probiotic administration on glucidic and lipidic profile was small (effect size (ES) 0.26 and 0.33, respectively), but better than in the control group, in whom the evolution was insignificant (ES 0.10 and 0.10, respectively). From a statistical point of view, the differences were insignificant (p>0.05). Conclusions. In the metabolic profile management of patients suffering from both MS and T2DM, probiotics administration had beneficial results, as highlighted by the results of the present study.
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- 2021
38. Observational study regarding risk factors and comorbitites for chronic kidney disease in diabetes mellitus patients from Bihor County
- Author
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Ioana Ratiu, Monica Sabau, Adriana Baidog, Amorin Remus Popa, Dorina Galusca, Gabriel Cristian Bako, Cosmin Mihai Vesa, and Pharmacy, Piata Demcembrie, no. , Oradea, Romania
- Subjects
medicine.medical_specialty ,Medicine (General) ,business.industry ,nutritional and metabolic diseases ,General Medicine ,risk factors for renal disease ,medicine.disease ,R5-920 ,Diabetes mellitus ,Internal medicine ,diabetes mellitus ,medicine ,Medicine ,Observational study ,business ,chronic kidney disease ,Kidney disease - Abstract
Introduction. Chronic kidney disease is a common comorbidity in diabetes mellitus type 2 patients because of presence of numerous risk factors such as obesity, hypertension, hyperglycemia and dyslipidemia. Material and methods. Our retrospective, observational study included 300 patients with type 2 diabetes mellitus from Bihor County and had the purpose to establish a clinical profile and to determine the risk factors associated with this pathology. Results. The prevalence of CKD was 75.67%. Older age, worse glucose control, presence of diabetic polyneuropathy and diabetic retinopathy, higher weight, past history of cardiovascular events, the presence of metabolic syndrome and hyperuricemia were associated with the presence of CKD. Conclusion. The clinical characteristics of type 2 diabetes mellitus patients with CKD is significantly worse compared with the population without CKD.
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- 2021
39. Congenital diaphragmatic hernia: a retrospective study regarding the clinical experience of Bihor County Genetics Center
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Romania Pharmacy 'Carol Davila' Bucharest, Dorina Galusca, Dana Carmen Zaha, Codruța Diana Petchesi, Alina Sklerniacof, Amorin Remus Popa, Emilia Severin, Kinga Kozma, Sânziana Jurca, Cristian Daina, Marius Bembea, Claudia Jurca, Cosmin Mihai Vesa, and Alexandru Daniel Jurcă
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,Genetics ,medicine ,Congenital diaphragmatic hernia ,Center (algebra and category theory) ,Retrospective cohort study ,medicine.disease ,business ,Agronomy and Crop Science ,Applied Microbiology and Biotechnology ,Biotechnology - Abstract
Congenital diaphragmatic hernia is an abnormality of embryologic development characterized by the persistence of communication between the thoracic and abdominal cavities, followed by an extremely high death rate despite medical progress. In Bihor county, according to a retrospective analysis of patient records from the Regional Center of Genetics, 30 children were diagnosed with congenital diaphragmatic hernia over a span of 28 years, from 1990 to 2018, most being male (73.3%). Predominant were the complex congenital diaphragmatic cases, meaning the cases of diaphragmatic hernia associated with other congenital abnormalities, 67% (20 patients) presenting at least one other congenital malformation. 95% (19 cases) of patients with complex congenital diaphragmatic hernia presented pulmonary abnormalities, the most frequent being pulmonary hypoplasia; 35% (7 cases) presented cardiac abnormalities. The Apgar score at 5 minutes after birth was significantly lower for patients with the clinical form of complex congenital diaphragmatic hernia. The mortality for the patients presenting the complex form was 100%, and for the patients presenting the isolated form was 20%. Karyotype analysis was performed for 17 patients, and 23.53% of them (4 patients) presented chromosomal abnormalities.
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- 2021
40. Epidemiology and pathophysiological mechanisms involved in alteration of glomerular function in diabetic patients
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Raluca Anca Corb Aron, Amorin Remus Popa, Marcel Stoita, Cosmin Mihai Vesa, Areha Abid, Timea Claudia Ghitea, and Gabriela Anca Angelescu
- Subjects
insulin ,lcsh:R5-920 ,medicine.medical_specialty ,endocrine system diseases ,diabetes ,business.industry ,lcsh:R ,lcsh:Medicine ,glomerular function ,General Medicine ,Bioinformatics ,Glomerular function ,Pathophysiology ,Epidemiology ,Medicine ,epidemiology ,lcsh:Medicine (General) ,business ,chronic kidney disease - Abstract
Chronic kidney disease of diabetic cause is a highly prevalent complication in diabetes mellitus patients. Complex phenotypes of the disease start to be recognized, such as albuminuria (micro- or macroalbuminuria) and non-albuminuric phenotype reduced glomerular filtration rate
- Published
- 2021
41. The non-invasive assessment of hepatic fibrosis
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Gabriela Ceobanu, Madalina Ilie, Nicolae Bacalbasa, Gina Gheorghe, Simona Bungau, Mihnea-Alexandru Găman, Cosmin Mihai Vesa, Camelia Cristina Diaconu, and Ovidiu Gabriel Bratu
- Subjects
Liver Cirrhosis ,medicine.medical_specialty ,Biopsy ,Disease ,Chronic liver disease ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Internal medicine ,medicine ,Humans ,Stage (cooking) ,medicine.diagnostic_test ,business.industry ,FibroTest ,General Medicine ,Gold standard (test) ,medicine.disease ,Liver ,030220 oncology & carcinogenesis ,Liver biopsy ,Elasticity Imaging Techniques ,030211 gastroenterology & hepatology ,Hepatic fibrosis ,business - Abstract
Hepatic disease accounts for approximately 2 million deaths/year worldwide. Liver fibrosis, as the last stage of numerous chronic liver diseases, is one of the most relevant prognostic factors. The liver biopsy with the histopathological examination is considered to be the "gold standard" for the identification and staging of the hepatic fibrosis. However, liver biopsy is known as an invasive investigation that has multiple limitations. Research studies conducted in the last few years focused on identifying non-invasive type methods for the evaluation of hepatic fibrosis; usually, there are 2 categories of such investigations: serologic tests and imaging techniques. This narrative review presents the non-invasive investigation methods used in the liver fibrosis evaluation. New molecular perspectives on fibrogenesis and fibrosis regression, as well as the appearance of therapeutic antifibrotic agents, justify the necessity of non-invasive tools to detect and grade liver fibrosis.
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- 2021
42. Recommendations Regarding Hyperglycaemia, Blood Pressure and Lipid Management in Diabetes Mellitus – Presentation of Key Aspects from the 2019 ESC/EASD Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases
- Author
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Loredana Popa, Mircea Ioachim Popescu, Lucia Daina, Gheorghe Carp, Amorin Remus Popa, Mihaela Popoviciu, Cosmin Mihai Vesa, and Monica Sabau
- Subjects
medicine.medical_specialty ,Lipid management ,business.industry ,030209 endocrinology & metabolism ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Blood pressure ,Pre diabetes ,Diabetes mellitus ,medicine ,Presentation (obstetrics) ,business ,Intensive care medicine - Abstract
The purpose of our review is to bring to the clinical specialities physicians’ attention the recommendations regarding diabetes mellitus (DM) management presented in the 2019 ESC/EASD Guidelines on diabetes, pre-diabetes and cardiovascular diseases. Key aspects from the guideline regarding blood pressure, lipid and glucose modern management are presented with focus of reducing cardiovascular risk in diabetes mellitus patients. The clinician must not forget that every DM patient is a candidate for a future cardiovascular event and that multifactorial and patient-adapted therapy is the key approach in reducing this risk.
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- 2021
43. Interrelationships between hyperuricemia, metabolic syndrome and chronic kidney disease in patients with diabetes mellitus
- Author
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Adriana Baidog, Tapan Behl, Ioana Ratiu, Francesca Ursu, Cosmin Mihai Vesa, Simona Bungau, Liviu Lazar, and Raluca Anca Corb Aron
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musculoskeletal diseases ,medicine.medical_specialty ,lcsh:R5-920 ,business.industry ,type 2 diabetes mellitus ,lcsh:R ,nutritional and metabolic diseases ,lcsh:Medicine ,General Medicine ,hyperuricemia ,medicine.disease ,urologic and male genital diseases ,Gastroenterology ,metabolic syndrome ,Diabetes mellitus ,Internal medicine ,medicine ,In patient ,Hyperuricemia ,Metabolic syndrome ,business ,lcsh:Medicine (General) ,chronic kidney disease ,Kidney disease - Abstract
Introduction. Hyperuricemia is a strong predictor of an altered metabolic status. There are complex interrelationships between hyperuricemia, type 2 diabetes mellitus (T2DM), metabolic syndrome (MS) and chronic kidney disease (CKD). The objective of the study was to investigate the impact of hyperuricemia on the prevalence of MS and glomerular function in patients with T2DM. Materials and methods. This retrospective study included 300 patients with T2DM, hospitalized for one day in the diabetes clinic, between 01.01.2016-31.12.2018; all the data used for the analysis were obtained from the medical records. Results. The prevalence of hyperuricemia was 46%. MS was identified in 88.41% patients with hyperuricemia compared to 61.73% in patients with normo-uricemia (p
- Published
- 2020
44. The Correlation of Vitamin D Level with Refractive Errors in Disabled Paediatric Patients
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Bianca Larisa Holhos, Claudia Teodora Judea Pusta, Simona Bungau, Liviu Lazar, Tapan Behl, Cosmin Mihai Vesa, Delia Mirela Tit, and Abbas Rahdar
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medicine.medical_specialty ,genetic structures ,Process equipment ,Materials Science (miscellaneous) ,Process Chemistry and Technology ,General Engineering ,General Chemistry ,General Medicine ,eye diseases ,General Biochemistry, Genetics and Molecular Biology ,Petrochemistry ,Materials Chemistry ,Vitamin D and neurology ,medicine ,Medical physics ,General Pharmacology, Toxicology and Pharmaceutics ,Paediatric patients - Abstract
Refractive errors are the most prevalent ocular disorders in paediatric ophthalmology having a higher occurrence in children with disabilities. This paper evaluated the refractive status of the disabled children and identified the influence of Vitamin D on this status. The study group was represented by 160 children (80 clinically healthy � group 0, 80 having different physical and/or mental disabilities � group 1) with ages between 5-16 years old, ophthalmologically examined between January 2019-January 2020. The prevalence of refractive errors was analysed according to the blood level of Vitamin D; the prevalence of the identified refractive errors was 35% in the group of children with disabilities (16% myopia, 14% astigmatism, 5% hyperopia) and 36% in the group of clinically healthy children (16% astigmatism, 10% myopia, 10% hyperopia). In group 1, an acceptable level (20-30 ng/mL) of Vitamin D was found in 61.54% of children with myopia, 25% in those with hyperopia, and 18.18% in those with astigmatism, the rest showing insufficiency of Vitamin D. Both children with disabilities/clinically healthy shown ocular refractive errors, the difference between the two groups being statistically insignificant (1%). The presence of Vitamin D in the blood in normal or insufficient levels suggests a strong correlation of its levels with the appearance of ocular refraction disorders.
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- 2020
45. Prediction Models of Albumin Renal Excretion in Type 2 Diabetes Mellitus Patients
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Amorin Remus Popa, Claudia Teodora Judea Pusta, Cosmin Mihai Vesa, Simona Bungau, Camelia Liana Buhas, Cristian Sava, Ioana Alina Dimulescu (Nica), Dana Carmen Zaha, and Cristiana Bustea
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endocrine system diseases ,Materials Science (miscellaneous) ,Process Chemistry and Technology ,Materials Chemistry ,General Engineering ,nutritional and metabolic diseases ,General Chemistry ,General Medicine ,General Pharmacology, Toxicology and Pharmaceutics ,General Biochemistry, Genetics and Molecular Biology - Abstract
Microalbuminuria is a cardiovascular risk factor in type 2 diabetes mellitus patients. It is very important to know which the predictor factors for albuminuria are, because these elements may be influenced by pharmacological measures. In our study we propose three models for the prediction of albumin glomerular excretion in a group of 446 type 2 diabetes mellitus patients: the clinical-biochemical model, the pharmacological model, and the integrative model that reunites the two models. In the clinical-biochemical model, albumin excretion was statistically significant influenced by HbA1c (positive correlation) and blood pressure (positive correlation). In the pharmacological model, albumin excretion was influenced by angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation). In the integrative model, the factors were HbA1c (positive correlation), diastolic blood pressure (positive correlation), angiotensin converting enzyme inhibitors or angiotensin II receptor blockers treatment (negative correlation) and statins treatment (negative correlation). The prevalence of microalbuminuria was 16.14 %. Patients with microalbuminuria had statistically significant higher values of HbA1c, systolic blood pressure, diastolic blood pressure, triglycerides and lower values of HDL-cholesterol. A low glucose control was the most important risk factor for an increased albumin glomerular elimination. The importance of our study consists in the fact that all the elements that predict albuminuria can be influenced: HbA1c, blood pressure, therapy with angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and statins.
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- 2019
46. Non-conventional therapeutical approaches to acne vulgaris related to its association with metabolic disorders
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Simona Gabriela Bungau, Delia Mirela Tit, Cosmin Mihai Vesa, Areha Abid, Denisa-Viola Szilagyi, Andrei-Flavius Radu, Alexa Florina Bungau, Alexandra Georgiana Tarce, Tapan Behl, Manuela Stoicescu, Cristina Mihaela Brisc, Daniela Gitea, Aurelia Cristina Nechifor, and Laura Endres
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Pharmacology ,Metabolic Syndrome ,Milk ,Acne Vulgaris ,Quality of Life ,Animals ,Humans ,Diet - Abstract
The ever-increasing frequency of metabolic syndrome (MetS) is still a major challenge of the public health care system, worldwide. In recent years, researchers have been drawn to the uncommon (at first look) link between skin illnesses and MetS. Because of the pro-inflammatory mechanisms and insulin resistance (IR) that are upregulated in metabolic syndrome, many skin disorders are correlated to metabolic dysfunctions, including acne vulgaris. A comprehensive understanding of the link between MetS and acne vulgaris may contribute to the development of new treatment strategies. The current review focuses on dietary and therapeutic interventions and assesses the effect of various approaches such as improving diet by avoiding certain food products (i.e., milk and chocolate) or increasing the intake of others (i.e., food products rich in omega-3 fatty acids), metformin administration, therapy with plant extracts, plant essential oils, and probiotic supplementation on the improvement of certain acne vulgaris severity parameters. These therapeutic approaches, when combined with allopathic treatment, can improve the patients' quality of life.
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- 2021
47. Highlighting the advantages and benefits of cementless total knee arthroplasty (Review)
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Aurelia Cristina Nechifor, Calin Tudor Hozan, Simona Bungau, Felicia Cioara, Tapan Behl, Teodor Andrei Maghiar, Octavian Maghiar, Bogdan Uivaraseanu, Jenel Marian Patrascu, Delia Mirela Tit, and Cosmin Mihai Vesa
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musculoskeletal diseases ,Oncology ,Cancer Research ,medicine.medical_specialty ,Oncogene ,business.industry ,Cell ,Total knee arthroplasty ,Cancer ,Review ,General Medicine ,Cell cycle ,medicine.disease ,Molecular medicine ,surgical procedures, operative ,medicine.anatomical_structure ,Immunology and Microbiology (miscellaneous) ,Internal medicine ,medicine ,business - Abstract
In the field of orthopedic surgery, cemented total knee arthroplasty (TKA) is considered to be one of the gold standards. However, there are categories of patients (i.e., obese and morbidly obese patients, younger than 65 years old) among whom cemented TKA has however a high failure rate. Moreover, the frequency of using uncemented TKA is increasing due to the potential benefits of long-term biological fixation, being an innovative field that addresses a new generation orthopedic surgical treatment which is more suitable for young patients who have good bone quality (good to very good, in terms of density). The survival rates and functional results of the latest generation of cementless TKAs may be similar to functional results and survival rates of cemented prosthesis. In conclusion, this review-type article can be considered a powerful database, extremely informative, dense, and focused on the topic mentioned above, in the interest of all medical professionals and all interested individuals.
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- 2021
48. Morbidity and Mortality in Patients with Acute Coronary Syn-drome with and Without Chronic Kidney Disease and Physicans Atitude Regarding Theraphy in the Two Groups
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Otilia Anca Țica, Adriana Ardelean, Mircea Ioachim Popescu, Carmen Dana Zaha, Mădălina Ioana Moisi, Cosmin Mihai Vesa, Larisa Roșan, and Babeș Katalin
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medicine.medical_specialty ,business.industry ,Internal medicine ,Public Health, Environmental and Occupational Health ,Medicine ,In patient ,Public aspects of medicine ,RA1-1270 ,business ,medicine.disease ,Letter to the Editor ,Kidney disease - Abstract
The article's abstract is not available.
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- 2021
49. Highlighting the Relevance of Gut Microbiota Manipulation in Inflammatory Bowel Disease
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Mirela Marioara Toma, Mihai Alexandru Munteanu, Delia Mirela Tit, Simona Bungau, Elena Emilia Babes, Flavia Maria Pavel, Cosmin Mihai Vesa, Camelia Cristina Diaconu, Manuela Stoicescu, and Gina Gheorghe
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0301 basic medicine ,Crohn’s disease ,Medicine (General) ,medicine.medical_treatment ,Clinical Biochemistry ,Review ,Gut flora ,Inflammatory bowel disease ,fecal microbiota transplant ,law.invention ,supplements ,03 medical and health sciences ,Probiotic ,0302 clinical medicine ,R5-920 ,law ,inflammatory bowel disease ,medicine ,Microbiome ,ulcerative colitis ,Crohn's disease ,biology ,gut microbiota ,business.industry ,Prebiotic ,biology.organism_classification ,medicine.disease ,phytochemicals ,Ulcerative colitis ,digestive system diseases ,030104 developmental biology ,probiotics ,Immunology ,030211 gastroenterology & hepatology ,business ,prebiotics ,Dysbiosis - Abstract
Two different conditions are included in inflammatory bowel disease (IBD), Crohn’s disease (CD) and ulcerative colitis (UC), being distinguished by chronic recurrence of gut inflammation in persons that are genetically predisposed and subjected to environmental causative factors. The normal structure of the gut microbiome and its alterations in IBD were defined in several microbial studies. An important factor in the prolonged inflammatory process in IBD is the impaired microbiome or “dysbiosis”. Thus, gut microbiome management is likely to be an objective in IBD treatment. In this review, we analyzed the existing data regarding the pathophysiological/therapeutic implications of intestinal microflora in the development and evolution of IBD. Furthermore, the main effects generated by the administration of probiotics, prebiotics, fecal transplantation, and phytochemicals supplementation were analyzed regarding their potential roles in improving the clinical and biochemical status of patients suffering from Crohn’s disease (CD) and ulcerative colitis (UC), and are depicted in the sections/subsections of the present paper. Data from the literature give evidence in support of probiotic and prebiotic therapy, showing effects such as improving remission rate, improving macroscopic and microscopic aspects of IBD, reducing the pro-inflammatory cytokines and interleukins, and improving the disease activity index. Therefore, the additional benefits of these therapies should not be ignored as adjuvants to medical therapy.
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- 2021
50. Evaluating the Efficacy of the Treatment with Benfotiamine and Alpha-lipoic Acid in Distal Symmetric Painful Diabetic Polyneuropathy
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Andrei Cristian Bondar, Octavian Maghiar, Carmen Pantis, Ioana Alina Dimulescu, Cosmin Mihai Vesa, Delia Carmen Nistor Cseppento, Amorin Remus Popa, Marius Rus, and Simona Bungau
- Subjects
Process equipment ,business.industry ,Materials Science (miscellaneous) ,Process Chemistry and Technology ,Alpha-Lipoic Acid ,General Engineering ,General Chemistry ,General Medicine ,Pharmacology ,General Biochemistry, Genetics and Molecular Biology ,Benfotiamine ,Diabetic polyneuropathy ,Materials Chemistry ,Medicine ,General Pharmacology, Toxicology and Pharmaceutics ,business ,medicine.drug - Abstract
Distal symmetric painful diabetic neuropathy is the most frequent clinical form of diabetic neuropathy. The condition appears as a result of alteration of the structure and function of nervous fibres as a consequence of hyperglycaemia. Hyperglycaemia determines the metabolism of glucose on alterative pathways and generates increased oxidative stress, mechanisms that cause an accelerated apoptosis of the neurons and a high intensity of lipid peroxidation. Pathogenic treatment of diabetic neuropathy includes limited options, two of them are: Benfotiamine (inhibits the metabolism of glucose on hexosamine pathway, reducing the formation of advanced glycosylation end products) and alpha-lipoic acid (has a scavenger effect on free radical species). The study included 120 patients with distal symmetric painful diabetic neuropathy randomized in 3 treatment groups. We evaluated the effect of oral administration for 8 weeks of Benfotiamine in a dosage of 300mg/day in monotherapy, of alpha-lipoic acid in a dosage of 600 mg/day in monotherapy, respectively of both -in combined therapy - on the parameters that are used to determine the severity of distal symmetric painful diabetic neuropathy: Diabetic Neuropathy Symptoms score, Neuropathy Disability Score and the intensity of lower limb pain on the visual analogue pain scale. All the three therapies were effective with a statistically significant improvement of these parameters, but the combined therapy with alpha-lipoic acid and Benfotiamine was superior to the monotherapy with alpha-lipoic acid or Benfotiamine.
- Published
- 2019
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